WASHINGTON - Sen. Bill Frist of Tennessee, the telegenic heart surgeon from Nashville who is poised to become Senate majority leader, seems to have made a career of being pressed into service.
A world-renowned physician who studied at Princeton and Harvard universities, he gave up an exciting and lucrative practice in 1994 to wrest a Senate seat from a powerful Democrat, 18-year veteran James R. Sasser.
When Republicans needed an energetic cheerleader and fund-raiser to plot a winning strategy to take back the Senate this year, Frist stepped up and delivered.
And last week, Frist emerged as if on a white horse to rescue his party from the furor surrounding Sen. Trent Lott of Mississippi and agreed to replace him as the Republican leader.
From the moment he arrived on Capitol Hill, Frist has impressed fellow senators with his intellect, work ethic and cool demeanor.
He makes it look easy.
To watch Frist, said Sen. Pete V. Domenici of New Mexico, is "to know that unless this man leaves the Senate unexpectedly, Bill Frist is going somewhere. America will meet an incredibly splendid man when they meet this guy."
Said former Tennessee Republican Sen. Howard H. Baker Jr., who served as majority leader: "I'm for Bill Frist for anything he's willing to do. ... There's no possible way they could do better than Bill Frist."
But underneath Frist's smooth and affable manner lies an intense personality as ambitious as it is hard-working. He may look as if he is being dragged into the spotlight, smiling coyly, but at each turn Frist has worked doggedly to position himself exactly where he wants to be.
"Once Bill puts his mind to something, you don't stop him," says Tom Perdue, an Atlanta-based Republican consultant who managed Frist's 1994 campaign.
And with his anticipated election tomorrow as Senate majority leader, the 50-year-old Frist is facing the toughest challenge of his short political career.
Frist, who is closely allied with President Bush and often mentioned as a presidential prospect in 2008, is putting his future on the line as he takes the top Senate Republican post, a role that often means being a punching bag for partisan attacks.
There are risks within his party as well. He is facing grumbling from colleagues that his ties to Bush will make him all too willing to do the bidding of the White House, and complaints from conservative activists who worry that he will not aggressively fight Democrats on key issues.
Record in Senate
Frist's voting record is as conservative as those of the top Senate Republican leaders; he earned a 100 percent rating last year from the American Conservative Union, and the National Right to Life Committee lists him as "pro-life."
He helped draft Bush's much-debated compromise on stem cell research, which allows government funds to be used to conduct research on existing stocks but not on cells from new human embryos. He has also supported the president's call for a ban on human cloning.
But from his earliest days campaigning in Tennessee, Frist has made a conscious effort to appeal to more moderate Republicans and conservative Democrats. He takes conservative positions but is willing to work across party lines to find pragmatic solutions to problems, particularly in the area of health care.
He worked with Sen. Edward M. Kennedy, a Massachusetts Democrat, on a bioterrorism preparedness measure this year. He has also supported several measures to increase access to health care and insurance, including a bill backed by President Bill Clinton to preserve the privacy of genetic information and prohibit insurers from denying coverage on the basis of genetic traits.
He has collaborated closely with Sen. John B. Breaux, a moderate Louisiana Democrat, on a Medicare reform initiative designed to bolster the federal health insurance program for the elderly by having the private sector play a greater role.
He has not reached a compromise with Democratic colleagues, however, on Medicare reform or on adding a prescription drug benefit to the program - two of the major goals of the new Congress, which convenes Jan 7.
Medical career
Observers say Frist owes at least some of his reputation as a moderate to his work outside the legislative realm. Colleagues from both sides of the aisle seem to trust Frist - who keeps his white lab coat and medical bag in the trunk of his car at all times - because he is there when they need him.
When a deranged gunman opened fire in the Capitol in 1998 and killed two police officers, Frist rushed to the scene to tend to the shooter. He also helped resuscitate Republican Sen. Strom Thurmond of South Carolina, then 98, when he collapsed on the Senate floor last year.
And he was the voice of calm and a fount of information for fearful lawmakers during the anthrax attacks on Capitol Hill last year. (Although he has been criticized for urging people to relax during a health crisis that turned out to be deadly.)
Frist brings his operating-room composure to his work on Capitol Hill, where colleagues and longtime associates say he is a tireless listener, determined student and persistent problem-solver.
"This is a guy that I've literally never seen at wits' end," said Mark Tipps, who was the senator's chief of staff when Frist arrived in Washington as a political neophyte who had never voted until 1989.
Born Feb. 22, 1952, Frist is the son of one of the most beloved families in central Tennessee. His father, the late Thomas H. Frist - whom most Tennesseeans simply know as "Dr. Frist" - founded Hospital Corp. of America, a chain of for-profit hospitals known as HCA.
After a childhood spent in the Nashville neighborhood of Belle Meade, Frist attended Princeton University and then Harvard Medical School, where he became enthralled with surgery.
His obsession with learning about organs and surgery bordered on the macabre when, by his own account, he began adopting cats from animal shelters around Boston - under the pretext of keeping them as pets - to kill and dissect them.
He has since denounced his actions as a "heinous and dishonest thing to do." In his book, Transplant: A Heart Surgeon's Account of the Life-and-Death Dramas of the New Medicine, Frist wrote that medical school "was in the business of stripping human beings of everything but the raw, almost insane ambition you must have simply to get through."
After surgical stints in Boston and abroad, Frist returned to Nashville and joined the faculty of the Vanderbilt University Medical Center, where he later founded a transplant center.
'Freeze the world out'
According to the campaign finance Web site Political Money Line, Frist spent $6.3 million of his own money on his 1994 Senate run against Sasser, whom he portrayed as a career politician too liberal for Tennessee.
Frist is well-known for not needing more than a few hours of sleep a night, is a licensed pilot and likes to run marathons.
"He can go longer without sleeping and longer without eating than anybody that I have ever worked with in my life," said consultant Perdue, who should know - they used to compete at it.
Friends and colleagues also marvel at Frist's ability to focus in the most distracting of environments.
"If you know how something works, and he does not, and you're going to show him, this look will literally come over his face, and he will freeze the world out," Perdue said.
'Herding cats'
But that, some Republican strategists believe, may not necessarily help Frist confront his biggest challenge in the weeks and months ahead. As majority leader, he will have to go beyond mastering complex subjects and learn the arts of party agenda-setting and political horse-trading as he goes.
"You're herding cats," one Republican strategist said of serving as majority leader. "He has no experience doing that."
Although he is well-versed on important issues such as health care and education, Frist has less expertise on issues such as taxes and the economy, which will figure prominently in the new Congress.
With his new position - to which Republicans are expected to elect him tomorrow - Frist will also come under greater scrutiny for his ties to the health care industry.
Frist has never been involved in running HCA, but he has made millions of dollars from owning company stock for most of his life.
The firm, run by his brother, Thomas Frist Jr., has been accused of Medicare fraud and overbilling. Last week, HCA made a deal with the Justice Department to pay the government $631 million to settle fraud claims - an amount some lawmakers in both parties say falls well short of what taxpayers deserve.